Get the message? A scoping review of physical activity messaging · 2020. 4. 15. · global burden...

REVIEW Open Access

Get the message? A scoping review ofphysical activity messagingChloë Williamson*, Graham Baker, Nanette Mutrie, Ailsa Niven and Paul Kelly

Abstract

Background: Understanding how to create and deliver effective physical activity (PA) messages for and to variouspopulation subgroups may play a role in increasing population PA levels. This scoping review aimed to provide anoverview of what is known about PA messaging and highlight key research gaps.

Methods: We followed a 5-stage protocol proposed by Arksey & O’Malley and the Preferred Reporting Items ForSystematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews checklist. Stage 1: research questionswere identified. Stage 2: we identified relevant studies by searching electronic databases, contacting existingnetworks and hand searching reference lists. Stage 3: studies were screened in Covidence™ software. Stage 4: studydata were extracted and charted. Stage 5: findings from included studies were collated, summarised and reportedin two ways: (1) a descriptive numerical analysis providing insight into extent, nature and distribution of theincluded studies, and (2) a narrative summary summarizing the evidence reviewed organised by messagingconcepts and by population subgroup.

Results: A total of 9525 references were imported into Covidence™ for screening. Of these, 123 studies wereincluded in final analysis. We found that PA messaging evidence is complex and multidimensional in nature, withnumerous concepts to consider when creating or evaluating messages. The extent to which these different PAmessaging concepts have been researched is variable. Where research has accumulated and evidence is consistent,it supports the following: (1) PA messages should be framed positively and highlight short-term outcomesspecifically relating to social and mental health, (2) message content should be tailored or targeted to intendedrecipient(s), and (3) when developing messages, formative research, psychological theory and/or social marketingprinciples should be used.

Conclusion: While it is unlikely to address global inactivity on its own, PA messaging may play a valuable roleimproving population PA levels. However, it is a complex and multidimensional concept and greater understandingis still needed. We present a synthesis of the existing evidence, highlighting key areas where evidence hasaccumulated and where gaps lie, as well as recommendations for PA messaging to different population subgroups.

Keywords: Exercise, Public health, Guidelines, Communication, Dissemination

© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License,which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you giveappropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate ifchanges were made. The images or other third party material in this article are included in the article's Creative Commonslicence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commonslicence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtainpermission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to thedata made available in this article, unless otherwise stated in a credit line to the data.

* Correspondence: [email protected] Activity for Health Research Centre (PAHRC), Institute for Sport,Physical Education and Health Sciences, University of Edinburgh, Edinburgh,UK

Williamson et al. International Journal of Behavioral Nutrition and Physical Activity (2020) 17:51 https://doi.org/10.1186/s12966-020-00954-3

http://crossmark.crossref.org/dialog/?doi=10.1186/s12966-020-00954-3&domain=pdf

http://creativecommons.org/licenses/by/4.0/

http://creativecommons.org/publicdomain/zero/1.0/

mailto:[email protected]

IntroductionPhysical inactivity is a major contributor to the growingglobal burden of non-communicable diseases includingcancer, cardiovascular disease, depression and diabetes[1]. Recent research shows that overall, global trends areworsening with physical inactivity levels rising in manyhigh-income Western countries and with the steadyprevalence of inactivity in low income countries makinga substantial contribution to the burden of disease [2]. Ithas been suggested that a systems approach may play animportant role in responding to complex public healthchallenges, such as efforts to increase PA at populationlevel [3–7]. A systems approach acknowledges thatalongside efforts to modify policy and the physical envir-onment to promote PA [8] there is an important role forinterventions which aim to address individual factors.One such approach is PA messaging.Interventions utilising a PA messaging approach tend to

feature the delivery of information to members of a targetgroup within the public with the aim of either directly orindirectly improving PA levels. Understanding how to util-ise PA messaging effectively is important for three rea-sons. Firstly, messaging is a scalable approach that can beused to reach large numbers of people at relatively lowcost [9]. Secondly, effective messaging can augment thedissemination of PA guidelines and related informationsuch as benefits of PA to various population subgroups, asthis information is generally not created to be public fa-cing or to motivate people to become or remain physicallyactive [10]. Indeed, evidence suggests that the generalpublic have limited knowledge of the current PA recom-mendations for health [11]. Thirdly, existing evidenceshows PA messaging interventions to date have had lim-ited effects on PA behaviour itself and mixed findings onoutcomes such as awareness and motivation [9, 10, 12–18]. Further research to understand how to effectively de-velop and deliver PA messages for and to different popula-tion subgroups is therefore warranted.In terms of previous research into PA messaging, a

number of reviews exist. While these reviews have focusedon specific aspects of messaging such as guideline dissem-ination [16, 17], solely on message content [10], specific-ally on mass media campaigns [9, 12, 13, 19], or onlyincluded research from the USA [18], no review that pro-vides a broad overview of the evidence on PA messagecontent and delivery from multiple countries across theglobe has been conducted. A summary paper which mapsand synthesises what is currently known across the vari-ous PA messaging concepts may be an important step inunderstanding how to optimally create and deliver effect-ive PA messages for various population subgroups. There-fore, the aim of this study was to provide the first suchbroad scoping of the evidence on PA messaging. Specific-ally, we sought to answer the following research questions:

(1) What is known about (a) PA message content and(b) PA message delivery?

(2) What is known about PA message content anddelivery for specific population groups?

(3) What are the research gaps?

MethodsStudy design and protocolBased on the study aim, a scoping review was deter-mined to be the most appropriate method. The aim wastoo broad to address via a traditional systematic review(and meta-analysis), and could be more appropriatelyanswered through examining the extent, range and natureof research in this area, summarising and disseminatingresearch findings to date, and identifying research gaps inthis area; all of which are common scoping review pur-poses [20]. The process of conducting a scoping review isoften iterative, allowing for changes to inclusion and ex-clusion critera, research questions and analytical ap-proaches as more is learned about the evidence base.Furthermore, a scoping review allows for inclusion of abroad range of study designs, providing a more compre-hensive picture of the research area. To ensure robustness,this study adopted an established five-stage scoping reviewprotocol proposed by Arksey & O’Malley [20] and builtupon by Levac, Colquhoun & O’Brien [21], and followedthe Preferred Reporting Items For Systematic Reviews andMeta-Analyses (PRISMA) extension for scoping reviewschecklist (Additional File 1) [22].

Key definitions and position of messagingHealth communication encompasses the study and useof communication strategies to inform, influence andmotivate individual, institutional and public audiencesabout important health issues [23]. At the outset of thisreview, we sought to define and position PA messagingwithin the wider context of health communication to in-form searches and inclusion criteria. We present PAmessaging as a subtype of health communication and asan overall concept that encompasses both content anddelivery aspects of a PA message. As no universally useddefinition of PA messaging exists, working definitionswere developed by the study authors for the purpose ofthis study (Table 1).Initial literature searching to establish an understand-

ing of key PA message and messaging terms revealedmultiple sub-concepts and inconsistencies in the use ofterminologies surrounding these. Indeed, these incon-sistencies and the need to take caution when comparingstudies have been previously noted [25]. One example ofthis are the terms tailoring and targeting. Although someauthors clearly distinguish between tailoring as an exclu-sively individual level approach and targeting as an ex-clusively group level approach [16], the term tailoring

Williamson et al. International Journal of Behavioral Nutrition and Physical Activity (2020) 17:51 of 15

has also been used to describe customisation of messagecontent at an individual level [26], and at a group level[27]. Similarly, the term targeting has been used to de-scribe a group-level approach [28] as well as to describeindividually-customised messages [29]. Thus, a glossaryof PA messaging sub-concepts and their working defini-tions for the purpose of this scoping review was createdand is presented in Table 2. Establishing these workingdefinitions was a fundamental step as it allowed us tostandardise information from various studies despite in-consistencies in terminologies used and thus reliably ex-tract data in Stage 4.

Stage 1: identifying the research questionOur research aim was to provide a broad overview ofwhat is known about PA messaging. To address thisaim, three specific research questions were identified.

(1) What is known about (a) PA message content and(b) PA message delivery?

(2) What is known about PA message content anddelivery for specific population groups?

(3) What are the research gaps?

Stage 2: identifying relevant studiesWe identified relevant studies by:

1. Searching the following electronic databases: Ovid(MEDLINE), ProQuest, SPORTDiscus (Ebscohost),and Web of Science

2. Contacting existing academic, policy and practicenetworks requesting relevant studies

3. Hand searching reference lists of key studies andchecking recent publications by key authors

The database search strategy was designed to be ascomprehensive as possible with the available resources.Databases were searched for titles that contained at leastone “PA” term as well as at least one “messaging” term(full list of search terms can be found in SupplementaryTable 1, Additional File 2). Appropriate truncation sym-bols and wild cards were used to account for searchterm variations and maximise searches. No limits onjournals searched were used. As an example, the fullelectronic search strategy for MEDLINE can be found inSupplementary Table 2, Additional File 2. Searches wereconducted up to August 30th, 2019. Inclusion and exclu-sion criteria (see Table 3) were designed to be highlyinclusive.

Stage 3: study selectionAll identified studies were uploaded to Covidence™ soft-ware where duplicates were automatically removed at

Table 1 Working definitions for the purpose of this research

Term Working definition

Physical activity messaging The overall process of designing, creating and delivering physical activity messages

Physical activity message Educational or persuasive material to be relayed to a specific individual or group within the public with the aim ofultimately increasing physical activity levels

Physical activity messagecontent

The specific aspects which comprise a PA message, such as the type, amount and presentation of information

Physical activity messagedelivery

The process by which a physical activity message is delivered to the target individual or group of the public

Definitions adapted from Latimer et al. [10] and drawing on Michie et al., intervention functions [24]

Table 2 Working definitions of key physical activity message content and delivery concepts

Working definition

Message Content

Type of information The nature or purpose of information included in the message. Messages identified in the literature can generally begrouped into three broad categories: ‘how much and what type’ information (such as physical activity guidelines), ‘why’information (such as benefits of physical activity), and ‘how to’ information (practical and supportive information).

Use of gain- or loss-framing [10]

The use of framing a message to highlight either the benefits of taking part in physical activity or the consequences ofnot taking part.

Tailoring [30] Information based on individual user data (e.g. specific feedback on pre-established goals such as step counts)

Targeting [30] Information designed to be relevant to a specific group (e.g. inactive individuals or diabetics)

Personalisation [30] The use of static, user-specific information in a message (e.g. name or home address).

Message Delivery

Media or mode of delivery The type of media through which the message is being relayed, for example, emails, posters or radio adverts.

Provider or source The provider or source of the message, for example, GP, the media, or friends and family.

Frequency and dose How often the message is delivered and for how long, for example, emails sent 3 times a week for 4 weeks.


time of upload. Titles and abstracts were screened byCW with 15% double screened by either GB or PK. Fulltext level reviewing was carried out by two independentresearchers (CW, PK, GB or AN) with conflicts resolvedby a third researcher.

Stage 4: charting the dataData were extracted and entered into a data chartingform using Excel. Where available, the data charted in-cluded all of the following:

� General study information including author, title,study location, study design and participantinformation

� Description of study and message used� Primary focus of study (message content, delivery or

both)� The use or absence of psychological theory� The use or absence of of social marketing principles

Key findings

� Implications

Stage 5: collating, summarising and reportingIn a scoping review, there are numerous ways in whichdata from identified studies can be organised, synthe-sised and reported. Findings of this scoping review werereported in two ways: (1) through a descriptive numer-ical analysis providing insight into extent, nature anddistribution of the included studies, and (2) through anarrative summary of the evidence base. To address ourresearch questions and maximise relevance for re-searchers, policymakers, practitioners and other relevantstakeholders, we made the decision to organise the nar-rative summary by the pre-identified messaging con-structs of content and delivery (see Table 2) as well asby UK Chief Medical Officer’s guideline groups (Chil-dren and Young People, Adults, Older Adults, PregnantWomen and Disabled People) [31]. Finally, a matrix dis-playing where consistent research had accumulated andwhere gaps lay, organised by messaging concept andpopulation group was created. This matrix displays

research areas across 5 levels of evidence from strong(e.g. systematic review level evidence) to non-existent(i.e. no research identified in this review) based on thenumber, type and agreement of findings across studiesrelating to each research area.

ResultsDescriptive numerical analysisA total of 9525 references were identified for screening(n = 9514 from database searches, n = 6 from existingnetworks, and n = 5 from hand searching). Following re-moval of duplicates and screening, 123 studies were in-cluded in final analysis. A study selection flowchart ispresented in Fig. 1.Of these 123 studies, 99 were empirical (original re-

search) and 24 were non-empirical (reviews, commen-tary, methods, etc). Of the 99 empirical studies, therewere 78 experimental studies (34 between-groups stud-ies, 16 pre-post, 13 randomised controlled trials, 6 cross-sectional, 4 within-subjects, 3 quasi-experimental, 1 lon-gitudinal, 1 post-test only, 1 single-group experiment,and 1 uncontrolled trial) and 21 non-experimental (18qualitative and 3 cross-sectional) studies. Of the non-empirical studies, there were 13 non-systematic reviews,6 systematic reviews, 3 commentaries, 1 conference fore-word, and 1 methods paper.The 99 empirical studies took place in the following

locations: Canada (n = 34), USA (n = 32), Australia (n =12), UK (n = 8), China (n = 2), France (n = 2), Germany(n = 2), Japan (n = 2), Belgium (n = 1), Brazil (n = 1),Ireland (n = 1), Netherlands (n = 1) and 1 took place inmultiple countries (Bulgaria, Croatia and Romania). Al-most half of the included studies (n = 58, 47.2%) werepublished in the past 5 years (2014–2019). The relevantguideline groups of the 123 studies were as follows:Adults (n = 61), Adults and Older Adults (n = 17), Chil-dren and Young People (n = 16), Children and YoungPeople & Adults (n = 9), Pregnant Women (n = 4), OlderAdults (n = 3), Disabled People (n = 3), and All (n = 10).Of the 99 empirical studies, 62 (62.6%) stated use of

psychological theory. The most commonly identifiedpsychological theories were Theory of Planned Behav-iour (n = 11), Social Cognitive Theory (n = 9), Self-

Table 3 Inclusion and exclusion criteria

Inclusion Criteria Exclusion Criteria

• Research articles or reports in any geographical location or setting• Research conducted in healthy or clinical populations• Articles published in peer-reviewed journals and grey literature• Articles reporting on development of or effects of PA messages• Articles published in English• Research designs including: empirical research studies (qualitative, cross-

sectional or longitudinal designs, interventions or natural experiments withpre-post measures or comparison) and non-empirical research (systematicand non-systematic reviews, and methods or theory papers)

• Articles focusing on wider PA communication not within the scope ofthis review, for example messages not directed to public or studiesusing other communication techniques such as one-to-one counselling

• Abstracts without full text


Determination Theory (n = 5) and Elaboration Likeli-hood Model (n = 4). Authors in 8 of the 99 empiricalstudies (18.2%) reported use of social marketing princi-ples, although no universally referred to set of principleswas apparent. Study descriptions, participant informa-tion, key findings and implications of these 123 studiesare presented in a Additional File 3. Of the 123 studies,60 primarily focused on message content, 6 primarily fo-cused on delivery, and 57 focused on both.

Narrative summary of findingsThe main findings around concepts relating to messagecontent (type of information, use of framing and use oftailoring or targeting), and message delivery (media ormode, provider/source and frequency & dose) (see Table2 for definitions) are summarised below. This scopingreview identified studies reporting on the following 11outcomes: message recall, messages awareness, messageappeal, message preference, affect, beliefs about PA, atti-tudes towards PA, PA intentions, self-efficacy, motiv-ation, and PA behaviour. These outcomes can be

broadly classified as proximal, intermediate or distal (seeTable 4).

Children and young peopleMessage contentEvidence from qualitative research [33, 34], existing re-views [17, 35] and experimental research [36] supportsthe use of messages targeting affective outcomes andhighlighting the social and mental health benefits of be-ing physically active (e.g. PA is fun and cool) in thispopulation. Although one experimental study found noadvantage for gain-framed messages over loss-framed inencouraging parent’s support for child PA [37], evidencefrom existing reviews and qualitative research generallysupports the use of gain-framed messages when focusingon children or their parents [17, 33, 38]. Messages tar-geting cognitive antecedents of PA specified by Theoryof Planned Behaviour (e.g. attitude) also had positive ef-fects on intentions to exercise [39].Mass media campaigns targeting children and young

people (namely the VERB [40] and WIXX [41]

Fig. 1 Study selection flowchart

Table 4 Working definitions of relevant outcomes

Outcomes The effects/impacts of the message

Proximal [32] Immediate impacts e.g. awareness and recall of the message.

Intermediate [32] Short term impacts e.g. intent, motivation, self-efficacy and knowledge.

Distal [32] Medium- and long-term impacts/outcomes e.g. physical activity behaviour(s).


campaigns) have had promising effects on PA [42] andon campaign recall and awareness [41, 43, 44]. Followingthe success of the social marketing-based VERB cam-paign, a 10-year review was published on how the cam-paign had informed other campaigns [45]. They foundevidence of numerous program planners having aspiredto follow the VERB approach, but few had taken advan-tage of the full capabilities of social marketing principlesto bring about changes in PA behaviour.

Message deliveryQualitative research suggests young people would preferto hear messages from adults other than general practi-tioners (GPs) or teachers whom they felt “lectured” by[33]. Rather, formative evidence supports delivering PAmessages to young people through mass media, websitesand smartphone apps [17]. Experimental and survey evi-dence also exists to support the use of video messagesover static images when targeting motivation and mes-sage recall [46, 47].

AdultsMessage contentExperimental evidence focusing on “how much” infor-mation (e.g. 150 min each week, 30 min × 5 days a week,or 10,000 steps each day) does not clearly support one‘amount’ or dose as the most effective message [48, 49].However, evidence does exist to suggest presenting 150min each week as a minimum threshold may be dam-aging to perceived benefits of shorter bouts of PA [50],and that adult populations (in a national survey) showhigh willingness to increase PA by short bouts (i.e. 10min per day) [51].Overall, existing evidence from formative research and

existing reviews supports the use of gain-framed mes-sages when targeting various outcomes for adults [10,17, 52–54]. Some experimental evidence from studiescomparing gain- and loss- framed message content intrial designs have found no significant difference in ef-fectiveness on proximal or distal outcomes in youngadults [55–58], adults over 55 years [56], inactive colo-rectal cancer survivors [59], or in community dwellingindividuals with multiple sclerosis [60]. However, an ad-vantage for gain-framed messages over loss-framed mes-sages has been found in general adult populations [10,61, 62], university students [63], overweight females [64],sedentary adults [65], and cardiac rehabilitation patients[66] on outcomes including attitude, exercise intentionsand PA behaviour. It also appears the effect of framingmay depend on the type of outcome emphasised and onthe individual’s need for cognition (i.e. an individual’stendency to enjoy activities that require thinking) [67],or on an individual’s emotional risk perception [68].Messages involving threat-based information or forceful

language appear to be ineffective or may even have detri-mental effects on PA and PA-related outcomes such asintentions, motivation and affect [69–72].Evidence from an existing scoping review suggests

mental health benefits are less frequently focused onthan physical health benefits in PA messages [18]. Des-pite a lack of focus, evidence from existing reviews,qualitative research and and experimental research sup-ports the use of messages highlighting short-term social(e.g. PA an opportunity to connect with others) andmental (e.g. improved mood and energy levels) healthbenefits in university students [73], adults [74–77] andspecifically in active adults [78] when targeting variousoutcomes including motivation and self-efficacy. Experi-mental evidence identified does not support the use ofappearance-based messages to improve PA intentions orattitudes in young adults [79, 80].This scoping review identified more evidence from ex-

perimental studies demonstrating a benefit of messagingtailoring (see Table 2) in improving PA behaviour, self-efficacy and feelings towards PA [10, 81–83] than nobenefit [26]. Experimental evidence also supports theuse of tailoring over simple personalisation of a genericmessage when targeting PA behaviour [81], and no evi-dence was found to support the use of non-tailored mes-sages over tailored messages. Qualitative research andexisting reviews support the use of psychological theoryto help identify behavioural determinants that messagescan be tailored to [10, 15]. This scoping review identifieda number of determinants by which messages could betailored to, namely: Stage of Change (as described inTranstheoretical Model) [10, 84], social support needs[84–86] and self-efficacy [10, 28]. The increasing poten-tial for intervention designers to create individually tai-lored messages due to advancements in technology isalso apparent in the evidence base [30, 87].The evidence supports the use of messages targeted to

specific demographics, such as women [88, 89] or younghealthy adults [56] to improve outcomes such as atti-tudes and intentions. Further, the importance of identi-fying and targeting to more specific populationsubgroups (such as education level, physical activitylevel, intention to be active, attitudes towards PA andperceived benefits of PA) beyond traditional demograph-ics (such as age and gender) was evident across multiplestudies and study types identified in this scoping review[25, 29, 53, 80, 82, 90–92].Previous reviews support the use of practical advice

and “how to” information in PA messages [10, 16, 74].Existing evidence also highlights the importance of in-cluding information that is relevant to the target audi-ence and using formative research to highlight what thespecific focus of messages should be. For example, quali-tative research suggests messages for women may


address identified barriers to women such as poor bodyimage [73, 93]. Mixed findings were found on the use ofdescriptive norm information (e.g. information aboutprevalence of PA amongst peers) on intentions and PAbehaviour in adults [94–97].One study found the use of spouse’s health risk infor-

mation to be promising in promoting PA in middle-agedadults [98], and another found active women had higherconfidence in response to reading information that PAwas preventive of heart disease compared to breast can-cer [99]. Potentially adverse effects of PA messages wereidentified in only one study, where recipients whoviewed exercise-related messages consumed more calo-ries post-message than those in control group [100].Numerous existing reviews focusing on mass media

campaigns targeting mixed adult populations were foundin this scoping review [9, 12, 13, 19, 32, 101–103] as wellas numerous evaluations of single mass media cam-paigns [47, 104–107]. Mixed findings were found for ef-fects of campaigns on proximal outcomes (e.g.awareness and campaign recall) and intermediate out-comes (e.g. intention to be active), but generally cam-paigns had less of an effect on intermediate outcomesthan on proximal. Campaign effects on distal outcomessuch as PA behaviour itself were modest and inconsist-ent, with few campaigns reporting increases. However,mass media campaigns specifically targeting walkinghave had positive effects on awareness [108–112], atti-tudes [111, 113, 114] and levels of walking [108–111].The evidence supports the use of social marketing

principles (e.g. branding and promotional strategies) inthe development of mass media campaigns [40, 45, 115],and suggests that interventions which use campaignbuilding principles or social marketing benchmarks (e.g.formative research, audience segmentation and channelplacement) are more successful in bringing about behav-iour change than those which do not use these principles[116, 117].

Message deliveryThe internet was found to be a common source of PAinformation in a general adult population [118], and in-terventions using the internet as a method of messagedelivery (e.g. email) have had promising results [119]. Interms of provider or messenger, the evidence from for-mative research supports the delivery of PA messagesthrough peers [28, 53, 74] in a general adult population.In terms of media or mode of message (see Table 2), thegeneral public find guideline documents unappealing[120], and the evidence from existing reviews and quali-tative research supports the use of commercial stylemessages [77, 120]. Mobile phone text messages havealso been successfully used in PA messaging interven-tions identified in this review [85, 121].

In terms of frequency and dose, when staff and stu-dents in UK universities received text messages on topof regular PA promotion emails, PA levels decreased sig-nificantly more than in the group that received emailsonly [122]. In young adults, evidence supports sendingshort messages [73] at times where there is opportunityto act on them (e.g. near morning or afternoon workbreak) [123], and a maximum of 2 messages per day[84]. Lastly, relating to media or mode of delivery, someexperimental evidence exists to support the use of im-ages in social media posts promoting PA [124].In terms of mass media campaigns, qualitative re-

search, experimental research and existing reviews iden-tified in this scoping review support the use of multiplemodalities (e.g. TV and billboard) of message delivery[47], the use of messages focusing on mental and socialhealth benefits [125], and working with local partner-ships to provide opportunities for the behaviours pro-moted in the campaign [126]. Longitudinal evidencefollowing campaign effects has shown disparaities be-tween high and low socio-economic status and betweenmajority and minority ethnic groups, highlighting theimportance of considering social inequalities when de-signing, implementing and evaluating mass media cam-paigns [127].

Older adultsMessage contentExperimental research in older adults supports theuse of gain-framed messages over loss-framed mes-sages in bringing about improvements in motivationand PA levels [55, 128, 129]. Qualitative evidence ex-ists to suggest messages to older adults should high-light the short term social and mental health benefitsof PA (e.g. feeling relaxed and connecting withothers) [74, 130]. Messages promoting mental imagery(e.g. encouraging older adults to imagine themselveswalking) may also be a promising approach to im-prove PA behaviour [131].

Message deliveryQualitative research in older adults has found that thispopulation have difficulty digesting technical language(e.g. ‘cardiovascular’ rather than ‘heart’) [74], and dislikethe format of existing PA guideline documents [130].Qualitative evidence also suggests older adults valuemessages from health care professionals (HCPs) andpeers [74, 132].

Pregnant womenMessage contentQualitative research found that pregnant women withGestational Diabetes want to feel confident about


being physically active during pregnancy, and thatthey would like practical information on safe physicalactivities they can take part in [133]. Empirical re-search suggests that appearance and health basedmessages were equally ineffective at improving inten-tions to exercise post-partum [134], but that persua-sive messages grounded in Theory of PlannedBehaviour resulted in significantly greater improve-ments in PA related outcomes than control [135].

Message deliveryQualitative research supports message delivery throughcredible sources such as HCPs in pregnant women[133]. A randomised controlled trial found that pregnantwomen who received 6 PA messages/week had greaterdecreases in PA and increases in sedentary time thanthose who received fewer messages [136].

Disabled peopleMessage contentA commentary on research conducted in disabled peoplesupports messages promoting short term affective out-comes of PA (e.g. PA makes you feel good, do what youenjoy) [137]. Qualitative research with disabled peopleand their carers has highlighted the importance of ac-knowledging the heterogeneity of disabilities and conduct-ing formative research to determine appropriate messagecontent and delivery methods [138]. Qualitative researchwith parents of disabled children supports the use of mes-sages including targeted information, inclusive images thatpromote belongingness, and messages providing self-regulatory tools [139]. One study conducted with commu-nity dwelling men and women with spinal cord injuryfound greater effects on proximal and intermediate out-comes following loss-framed messages targeting psycho-logical health than gain-framed messages [140].

Message deliveryIn parents of disabled children, qualitative research hasrevealed that preferred PA message providers are reliableand credible organisations, other parents [37], and theschool [138]. Role models (e.g. coaches or mentors),doctors, psychologists, physiotherapists, social workersand peers have also been highlighted as important mes-sengers for disabled people [137, 138]. Communitydwelling people with spinal cord injury stated preferencemessages delivered via the internet and via HCPs [132].

Gaps in the literatureWith the findings from studies summarised above, it isalso helpful to consider an overview of where evidencehas and has not accumulated on the topic of PA messa-ging. Overall, studies more frequently focused on aspects

of message content than on aspects of message delivery,and on adults more than other populations. A matrixdisplaying where evidence has accumulated and whereevidence is lacking (based on the studies reviewed) isdisplayed in Fig. 2.

DiscussionSummary of principal findingsThis scoping review aimed to map the literature on PAmessaging and identify key research gaps. We found thatPA messaging is complex and multidimensional in na-ture, with numerous concepts to consider when creatingor evaluating messages. The extent to which each indi-vidual concept has been researched across different pop-ulations is variable and for many concepts there is noclear consensus on how to optimally design or deliverPA messages. However, the review has successfullymapped where evidence has accumulated and whereclear gaps exist. Where consistent evidence does exist, itsuggests that PA messages should be gain-framed,should highlight short-term outcomes (specifically relat-ing to social and mental health), message content shouldbe tailored or targeted, and formative research, psycho-logical theory and/or social marketing principles shouldbe used in message development.

Comparison with literature and plausible explanations forfindingsOur principal findings agree with those from another re-cent scoping review [18] that reviewed PA communica-tion efforts solely in the USA from 1995 to 2015. Theauthors of that review found that 68% of messages weregrounded in theory with the majority of communicationresearch being conducted in adult populations [18].They also recommended that PA campaigns should usevisual content such as videos, content targeted to spe-cific populations, and multiple modalities to deliver mes-sages [18]. Our scoping review builds on these findingsby providing an up to date overview of PA messaging re-search evidence from multiple countries across the globeand making recommendations for population groupsaligning with PA for health guidelines (see Table 5below). Our review also supports findings from a sys-tematic review of different approaches to PA messageconstruction [10]. In line with our findings, Latimeret al., found a benefit for gain-framed messages overloss-framed messages, found that message tailoring isimportant for success, and found messages targeting thepsychological determinant of self-efficacy to be beneficialbut concluded that overall understanding of PA messa-ging was lacking [10].Evidence from this scoping review supports the use of

gain-framed messages. Message framing originates fromProspect Theory, which suggests individuals will respond


differently to factually equivalent messages dependingon whether they are worded to highlight benefits or con-sequences [141]. The benefit of gain-framing over loss-framing in promoting PA may be partially due to thegreater ability or likelihood of a gain-framed messages toinclude information targeting psychological determi-nants of PA. For example, it would be difficult to con-struct a loss-framed message that aimed to improve anindividual’s self-efficacy. This links with the finding thatmessages are more promising when grounded in psycho-logical theory. This is not surprising, as the importanceof using theory in the development of public health in-terventions is widely recognised [142] although we ac-knowledge this is a currently debated topic in theliterature [143]. The evidence supporting the use of

tailoring or targeting in PA messaging is also intuitive. Itis believed that customising a message increases messagesalience [144], which leads to greater information pro-cessing and behaviour change [145, 146].In a field where the physical long-term health benefits

of taking part in PA are often at the forefront of epi-demiology and subsequent communications, an import-ant finding of this scoping review is that evidencesupports the use of messages highlighting short-termoutcomes, particularly those relating to mental and so-cial health. This finding may relate to social marketing,which involves applying marketing techniques to influ-ence human behaviour for social good and to improvehealth outcomes [147]. Social marketing involves pre-senting a product (in this case PA) in exchange for a

Fig. 2 Matrix displaying where research evidence relating to physical activity messaging has accumulated and where gaps lie


cost (in this case somebody’s time, energy, or other po-tential resources). To market such a product effectivelyto an individual, it is important we make it as appealingas possible. It seems logical then that an individual mayrespond better to what they can get out of ‘buying into’this product immediately (e.g. feel good, have more en-ergy, spend time with others) than what they may getout of it later (e.g. reduced risk of cardiovascular diseaselater in life). An individual may know that eating cakeregularly could increase their risk of weight gain andnegatively affect their health, but they may continue todo so for the immediate enjoyment of eating cake. Socialmarketing therefore highlights the importance of utilis-ing affective and emotional responses to make a ‘prod-uct’ more appealing [147], and this aligns with creatingmessages that depict PA as, for example, fun, enjoyable,or an opportunity to spend time with loved ones.

Future research and implicationsOur findings show an increasing interest in the area ofPA messaging, with almost half of the studies identifiedpublished in the past 5 years. In terms of future research,there is a need for instructive studies with appropriateevaluative designs to systematically isolate and test indi-vidual components of message content and delivery foreffectiveness, and thus develop our understanding of op-timal PA content and delivery in different populationsubgroups. Such research efforts should prioritise PAthe messaging concepts identified in this review as hav-ing little or no evidence focusing on them (e.g. messagedose and frequency in all populations, see Table 5). Inareas where evidence has accumulated but has not yetbeen synthesised (e.g. type of information in adults, seeTable 5), systematic reviews with meta-analyses are also

warranted. Qualitative research and mediator analysis tohelp gain a greater understanding of the specific mecha-nisms by which existing PA messages work (i.e. whichpsychological determinants are affected by PA mes-sages), or which outcomes future PA messages shouldtarget is also required to enhance our understanding ofPA messaging. Also, although we attempted to identifycommonly used theories from included studies, numerouspotentially important theories were not discussed in thisreview (e.g. Knowledge Gap Hypothesis and ElaborationLikelihood Model). Therefore, to further enhance our un-derstanding of PA messaging, a specific review of the roleof theories and the extent to which they have been used inPA messaging using existing guidance [148] may also bewarranted. Lastly, due to the complex and multidimen-sional nature of PA messaging highlighted in this review,there is a need to organise and conceptualise the area ofPA messaging to encourage further understanding of, andapplication in, this area.The findings of this research are timely as they could

inform the dissemination of newly developed, or updatedguidelines to various populations [31, 149–151]. Atcurrent, the World Health Organistion (WHO) are up-dating global PA guidelines, and these findings may aidtheir communication and dissemination plans. In theUK specifically, the Updated Chief Medical Officers’(CMO) guidelines (released on September 9th 2019)state that a Communications Working Group is beingestablished to advise approaches to communicating PArecommendations and related messages to the widerpublic [31]. Based on key findings, recommendationswhich could be used by such working groups to aid de-velopment of PA messages to each guideline group arepresented below (Table 5).

Table 5 Physical activity message recommendations based on summary of findings

Guideline group Physical activity message recommendations

Children and youngpeople

• Messages to this population should be framed positively, highlighting the benefits of physical activity. Specifically,messages should highlight the social and acute affective benefits of physical activity, for example, “physical activity is fun”.

• Messages to this population should be delivered via engaging modes such as videos and should be delivered throughinformal sources such as smartphone apps or the media.

Adults • Messages to this population should be framed positively, with specific focus on social and mental health benefits ofphysical activity, for example, “physical activity makes you feel good”.

• Messages should be brief and should avoid threat-based language. To the general adult population, informal modes of de-livery are encouraged such as through the media.

• In clinical populations, messages should be delivered through health care professionals.

Older adults • Messages to this population should be framed positively, with specific focus on social and mental health benefits ofphysical activity, for example, “physical activity is an opportunity to connect with others”.

• Messages delivered through health care professionals are likely to be well-received

Pregnant women • Messages to this population should include clear and practical information on physical activity during pregnancy, forexample, messages could include examples of safe exercises.

• Messages should be delivered through credible sources such as health care professionals.

Disabled people • Messages to this population should highlight short-term affective benefits of physical activity and should use inclusiveimages.

• Messages should be delivered through credible organisations, health care professionals and social workers.


Strengths and limitationsThis scoping review is the first to attempt to provide anoverview of available evidence on PA messaging fromacross multiple countries. A key strength of this scopingreview is its inclusivity of a range of study designs, allow-ing us to provide a more comprehensive overview of theevidence base. Further strengths of this scoping review in-clude the use of established protocol [20–22], and presen-tation of findings by key concepts and population groups.This review has produced meaningful findings which mayaid dissemination of PA guidelines (such as the under-development new WHO Global PA guidelines or thenewly released UK PA guidelines for health [31]) and re-lated information to various population subgroups.Due to the nature of scoping reviews, we did not ap-

praise the quality of evidence included. We are also un-able to comment on the effectiveness of differentmessaging techniques as the heterogeneous nature of in-cluded studies do not allow for meta-analysis, and in-deed that is not the aim of a scoping review [20]. Rather,we have presented a descriptive account of available re-search. Another limitation of this scoping review is thatonly titles were searched due to the time and resourceconstraints. This limitation means that some relevantstudies were missed. For example, although our reviewidentified the Canadian campaign ParticipACTION [46],not all publications on this campaign were identified dueto the limitations of our search terms [152]. Indeed,given the nature of PA messaging, it could be arguedthat it is impossible for one review to completely captureall of the available evidence in this area. However, a sub-stantial body of literature was generated (123 studies);almost double the number identified in a previous scop-ing review of PA communication in the USA alone [18].We are confident we have included a range of studiesthat adequately provide an overview of the PA messa-ging evidence base, and which is sufficient in addressingour aims. Finally, there are likely lessons to be learnedfrom other forms of PA communication (e.g. one-to-onecounselling) however, these were deemed to be outsidethe scope of this study and therefore not included. Iso-lating PA messaging to the public from other forms ofcommunication was necessary to focus our study anddevelop our understanding of PA messaging and its ap-plication in this area.

ConclusionWhile it is unlikely to address global inactivity on itsown, PA messaging may play a significant role in target-ing individual factors in a systems approach to improvePA population levels, but is a complex and multidi-mensional concept. We present a synthesis of the PAmessaging evidence from across the globe, highlight-ing key areas where evidence has accumulated and

where gaps exist. We provide recommendations forPA messaging to different population groups. Head-line findings include support for the use of gain-framed messages highlight short-term mental and so-cial health outcomes, tailored or targeted messages,and messages grounded in psychological theory or so-cial marketing principles. Further instructive researchis required to understand how to optimally messagePA information to different populations.

Supplementary informationSupplementary information accompanies this paper at https://doi.org/10.1186/s12966-020-00954-3.

Additional file 1. PRISMA Scoping Review Checklist.

Additional file 2. Search terms and strategy.

Additional file 3. Supplementary datasheet of included studies.

AbbreviationsPA: physical activity; HCP: health care professional; GP: general practitioner;CMO: chief medical officers; UK: United Kingdom; USA: United States ofAmerica

AcknowledgementsThis article is part of the PhD project of the first author, CW, supervised byPK and GB. We would like to thank the PhD steering group. The authorswould also like to acknowledge Professor Mary Brennan and Dr. Karen Miltonfor their feedback.

Authors’ contributionsCW and PK conceived the study. CW, PK and GB designed the searchstrategy. CW conducted database searches. CW, PK, GB and AN screenedrecords and extracted data. CW, PK, GB and NM led analysis of results. CWdrafted the full manuscript, and all authors reviewed and approved for finalsubmission.

FundingThis research was conducted as part of CW’s PhD which is funded by aPrincipal’s Career Development Scholarship, University of Edinburgh,Scotland, UK. The University Scholarship is unrestricted and played no role inthe conception, design and reporting of this study.

Availability of data and materialsDetails of reviewed articles are available in Additional File 3.

Ethics approval and consent to participateNot applicable.

Consent for publicationNot applicable.

Competing interestsThe authors declare that they have no competing interests.

Received: 17 January 2020 Accepted: 2 April 2020

References1. Lee IM, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT. Effect of physical

inactivity on major non- communicable diseases worldwide: an analysis ofburden of disease and life expectancy. Lancet. 2012;380(9838):219–29.

2. Guthold R, Stevens GA, Riley LM, Bull FC. Worldwide trends in insufficientphysical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1·9 million participants. Lancet Glob Health. 2018;6(10):e1077–e86.


https://doi.org/10.1186/s12966-020-00954-3

https://doi.org/10.1186/s12966-020-00954-3

3. Rutter H, Savona N, Glonti K, Bibby J, Cummins S, Finegood DT, et al. Theneed for a complex systems model of evidence for public health. Lancet.2017;390(10112):2602–4.

4. Peters D. The application of systems thinking in health: why use systemsthinking? Health Res Policy Syst. 2014;12(1):51.

5. Hawe P, Shiell A, Riley T. Theorising interventions as events in systems. Am JCommunity Psychol. 2009;43(3–4):267–76.

6. Friel S, Pescud M, Malbon E, Lee A, Carter R, Greenfield J, et al. Usingsystems science to understand the determinants of inequities in healthyeating. PLoS One. 2017;12(11):e0188872.

7. Rutter H, Cavill N, Bauman A, Bull F. Systems approaches to global andnational physical activity plans. Bull World Health Organ. 2019;97(2):162–5.

8. Sallis JF, Bauman A, Pratt M. Environmental and policy interventions topromote physical activity; 1998. p. 379–97.

9. Cavill N, Bauman A. Changing the way people think about health-enhancing physical activity: do mass media campaigns have a role? J SportsSci. 2004;22(8):771–90.

10. Latimer AE, Brawley L, Bassett R. A systematic review of three approachesfor constructing physical activity messages: What messages work and whatimprovements are needed? Int J Behav Nutr Phys Act. 2010.

11. Scottish Government. Scottish health survey: Main report. 2012.12. Brown DR, Soares J, Epping JM, Lankford TJ, Wallace JS, Hopkins D, et al.

Stand-alone mass media campaigns to increase physical activity:acommunity guide updated review: a community guide updated review. AmJ Prev Med. 2012;43(5):551–61.

13. Finlay S-J, Faulkner G. Physical activity promotion through the mass media:inception, production, transmission and consumption. Prev Med. 2005;40(2):121–30.

14. Leavy J, Rosenberg M, Bull F, Corti BG, Shilton T, Maitland C, et al. Effects ofFind Thirty every day: Cross sectional findings from a Western Australianpopulation wide mass media campaign 2008–2010. J Sci Med Sport. 2011;14:e27-e.

15. Berry TR, Latimer-Cheung AE. Overcoming challenges to build strongphysical activity promotion messages. Am J Lifestyle Med. 2013;7(6):371–8.

16. Brawley LR, Latimer AE. Physical activity guides for Canadians: messagingstrategies, realistic expectations for change, and evaluation. Can J PublicHealth. 2007;98(Suppl 2):S170.

17. Latimer-Cheung AE, Rhodes R, Kho ME, Tomasone JR, Gainforth HL,Kowalski K, et al. Evidence-informed recommendations for constructing anddisseminating messages supplementing the new Canadian Physical ActivityGuidelines. BMC Public Health. 2013;13:419.

18. Bergeron CD, Tanner AH, Friedman DB, Zheng Y, Schrock CS, Bornstein DB,et al. Physical activity communication: a scoping review of the literature.Health Promot Pract. 2019;20(3):344–53.

19. Leavy JE, Bull FC, Rosenberg M, Bauman A. Physical activity mass mediacampaigns and their evaluation: a systematic review of the literature 2003-2010. Health Educ Res. 2011;26(6):1060–85.

20. Arksey H, Malley L. Scoping studies: towards a methodological framework.Int J Soc Res Methodol. 2005;8(1):19–32.

21. Levac D, Colquhoun H, Brien KK. Scoping studies: advancing themethodology. Implement Sci. 2010;5(1) <xocs:firstpage xmlns:xocs=""/>.

22. Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, et al. PRISMAextension for scoping reviews (PRISMA-ScR): checklist and explanation. AnnIntern Med. 2018;169(7):467.

23. US Department of Health and Human Services. Healthy People 2010 FinalReview. p. 2010.

24. Michie S, VMM S, West R. The behaviour change wheel: a new method forcharacterising and designing behaviour change interventions. ImplementSci. 2011;6.

25. Yap T, Davis S. Physical activity: the science of health promotion throughtailored messages. Rehabil Nurs. 2008;33(2):55–62.

26. Martinez JL, Duncan LR, Rivers SE, Latimer AE, Salovey P. Examining the useof message tailoring to promote physical activity among medicallyunderserved adults. J Health Psychol. 2013;18(4):470–6.

27. Yan A. MHealth text messaging for physical activity promotion incollege youth: a participatory approach. Ann Behav Med. 2015;49(s1):S201-S.

28. Marmo J. Applying social cognitive theory to develop targeted messages:college students and physical activity. West J Commun. 2013;77(4):444–65.

29. Berry TR. Changes in implicit and explicit exercise-related attitudes afterreading targeted exercise-related information. Psychol Sport Exerc. 2016;22:273–8.

30. Conroy DE, Hojjatinia S, Lagoa CM, Yang C-H, Lanza ST, Smyth JM.Personalized models of physical activity responses to text message micro-interventions: a proof-of-concept application of control systems engineeringmethods. Psychol Sport Exerc. 2019;41:172–80.

31. Scottish Government. UK chief medical Officers’ physical activity guidelines.2019.

32. Bauman A, Chau J. The role of media in promoting physical activity. J PhysAct Health. 2009;6(2):S196–210.

33. Nicholson L. Development of key themes for physical activity promotion forthe early years, children and young people; 2012.

34. Bellows L, Spaeth A, Lee V, Anderson J. Exploring the use of storybooks toreach mothers of preschoolers with nutrition and physical activitymessages. J Nutr Educ Behav. 2013;45(4):362–7.

35. Alberga A, Fortier M, Bean C, Freedhoff Y. Youth get a D+ grade in physicalactivity: how can we change public health messages to help reverse thistrend? Appl Physiol Nutr Metab. 2019;44:567–70.

36. Sirriyeh R, Lawton R, Ward J. Physical activity and adolescents: an exploratoryrandomized controlled trial investigating the influence of affective andinstrumental text messages. Br J Health Psychol. 2010;15(4):825–40.

37. Bassett-Gunter R, Stone R, Jarvis J, Latimer-Cheung A. Motivating parentsupport for physical activity: the role of framed persuasive messages. HealthEduc Res. 2017;32(5):412–22.

38. Jarvis J, Gainforth H, Latimer-Cheung A. Investigating the effect of messageframing on parents’ engagement with advertisements promoting childphysical activity. Int Rev Public Nonprofit Market. 2014;11(2):115–27.

39. Hill C, Abraham C, Wright DB. Can theory-based messages in combinationwith cognitive prompts promote exercise in classroom settings? Soc SciMed. 2007;65(5):1049–58.

40. Wong F, Huhman M, Heitzler C, Asbury L, Bretthauer-Mueller R, McCarthy S,et al. VERB - a social marketing campaign to increase physical activityamong youth. Prev Chronic Dis. 2004;1(3):A10.

41. Bélanger-Gravel A, Gauvin L, Lagarde F, Laferté M. Initial recall andunderstanding of a multimedia communication campaign to promotephysical activity among tweens: a process evaluation study. Prev Med. 2014;69:192–6.

42. Huhman M, Potter LD, Wong FL, Banspach SW, Duke JC, Heitzler CD. Effectsof a mass media campaign to increase physical activity mmong children:year-1 results of the VERB campaign.(Author Abstract). Pediatrics. 2005;116(2):487.

43. Bélanger-Gravel A, Cutumisu N, Gauvin L, Lagarde F, Laferté M. Correlates ofinitial recall of a multimedia communication campaign to promote physicalactivity among tweens: the WIXX campaign. Health Commun. 2017;32(1):103–10.

44. Bélanger-Gravel A, Cutumisu N, Lagarde F, Laferté M, Gauvin L. Short-termimpact of a multimedia communication campaign on Children’s physicalactivity beliefs and behavior. J Health Commun. 2017;22(1):1–9.

45. Huhman M, Kelly R, Edgar T. Social marketing as a framework for youthphysical activity initiatives: a 10-year retrospective on the legacy of CDC’sVERB campaign. Curr Obes Rep. 2017;6(2):101–7.

46. Deshpande S, Berry TR, Faulkner GEJ, Latimer-Cheung AE, Rhodes RE,Tremblay MS. Comparing the influence of dynamic and static versions ofMedia in Evaluating Physical-Activity-Promotion ads. Soc Marketin Quart.2015;21(3):135–41.

47. Peterson M, Chandlee M, Abraham A. Cost-effectiveness analysis of astatewide media campaign to promote adolescent physical activity. HealthPromot Pract. 2008;9(4):426–33.

48. Murtagh EM, Archibald K, Doherty A, Mutrie N, Breslin G, Lambe B, et al. 150minutes per week or 30 minutes on 5 days? The effect of brief advice aboutphysical activity recommendations on moderate-to-vigorous activity ofinactive adults. In: Limerick Uo, editor. 2014.

49. Pal S, Cheng C, Ho S. The effect of two different health messages onphysical activity levels and health in sedentary overweight, middle-agedwomen. BMC Public Health. 2011;11:204.

50. Knox ECL, Webb OJ, Esliger DW, Biddle SJH, Sherar LB. Using thresholdmessages to promote physical activity: implications for public perceptionsof health effects. Eur J Public Health. 2014;24(2):195–9.


51. Miyachi M, Tripette J, Kawakami R, Murakami H. “+10 min of physical activityper day”: Japan is looking for efficient but feasible recommendations for itspopulation. J Nutr Sci Vitaminol. 2015;61:S7–9.

52. Adams R. Shown to be useful. Survey shows positive results for first-ever setof national physical activity guidelines. Can Fam Physician. 2000;46:2061–2.

53. Black DR, Blue CL, Kosmoski K, Coster DC. Social marketing: developing atailored message for a physical activity program. Am J Health Behav. 2000;24(5):323–37.

54. Mendez RDR, Rodrigues RCM, Spana TM, Cornélio ME, Gallani MCBJ, Pérez-Nebra AR. Validation of persuasive messages for the promotion of physicalactivity among people with coronary heart disease. Rev Lat AmEnfermagem. 2012;20(6):1015–23.

55. Notthoff N, Carstensen LL. Positive messaging promotes walking in olderadults. Psychol Aging. 2014;29(2):329–41.

56. Berry TR, Carson V. Ease of imagination, message framing, and physicalactivity messages. Br J Health Psychol. 2010;15(1):197–211.

57. Kin-Kit L, Sheung-Tak C, Fung HH. Effects of message framing on self-reportand accelerometer-assessed physical activity across age and gender groups.J Sport Exerc Psychol. 2014;36(1):40–51.

58. Bassett-Gunter RL, Latimer-Cheung AE, Martin Ginis KA, Castelhano M. I spywith my little eye: cognitive processing of framed physical activitymessages. J Health Commun. 2014;19(6):1–16.

59. Hirschey R, Lipkus I, Jones L, Mantyh C, Sloane R, Demark-Wahnefried W.Message framing and physical activity promotion in colorectal cancersurvivors.(Report). Oncol Nursing Forum. 2016;43(6):697.

60. Lithopoulos A, Bassett-Gunter RL, Martin Ginis KA, Latimer-Cheung AE. Theeffects of gain- versus loss-framed messages following health riskinformation on physical activity in individuals with multiple sclerosis. JHealth Commun. 2017;22(6):523–31.

61. Sweet SN, Brawley LR, Hatchell A, Gainforth HL, Latimer-Cheung AE. Canpersuasive messages encourage individuals to create action plans forphysical activity? J Sport Exerc Psychol. 2014;36(4):413–23.

62. van’t Riet J, RAC R, Werrij MQ, de Vries H. Investigating message-framingeffects in the context of a tailored intervention promoting physical activity.Health Educ Res. 2010;25(2):343–54.

63. Jones LW, Sinclair RC, Courneya KS. The effects of source credibility andmessage framing on exercise intentions, behaviors, and attitudes: anintegration of the elaboration likelihood model and Prospect Theory1. JAppl Soc Psychol. 2003;33(1):179–96.

64. Kozak AT, Nguyen C, Yanos BR, Fought A. Persuading students to exercise:what is the best way to frame messages for Normal-weight versusoverweight/Obese University students? J Am Coll Heal. 2013;61(5):264–73.

65. Latimer AE, Rench TA, Rivers SE, Katulak NA, Materese SA, Cadmus L, et al.Promoting participation in physical activity using framed messages: anapplication of prospect theory. Br J Health Psychol. 2008;13(4):659–81.

66. McCall LA, Ginis KAM. The effects of message framing on exerciseadherence and health beliefs among patients in a cardiac rehabilitationprogram. J Appl Biobehav Res. 2004;9(2):122–35.

67. Gallagher KM, Updegraff JA. When 'fit' leads to fit, and when 'fit' leads tofat: how message framing and intrinsic vs. extrinsic exercise outcomesinteract in promoting physical activity. Psychol Health. 2011;26(7):819–34.

68. Michalovic E, Hall S, Duncan LR, Bassett-Gunter R, Sweet SN. Understandingthe effects of message framing on physical activity action planning: the roleof risk perception and elaboration. Int J Behav Med. 2018;25(6):626–36.

69. Kang Y, O’Donnell MB, Strecher VJ, Falk EB. Dispositional mindfulnesspredicts adaptive affective responses to health messages and increasedexercise motivation.(Report)(Author abstract). Mindfulness. 2017;8(2):387.

70. Quick BL, Considine JR. Examining the use of forceful language whendesigning exercise persuasive messages for adults: a test ofconceptualizing reactance arousal as a two-step process. HealthCommun. 2008;23(5):483–91.

71. Hatchell AC, Bassett-Gunter RL, Clarke M, Kimura S, Latimer-Cheung AE.Messages for men: the efficacy of EPPM-based messages targeting Men'sphysical activity. Health Psychol. 2013;32(1):24–32.

72. Brengman M, Wauters B, Macharis C, Mairesse O. Functionaleffectiveness of threat appeals in exercise promotion messages.Psicologica. 2010;31(3):577–604.

73. Reese JM, Joseph RP, Cherrington A, Allison J, Kim Y-I, Spear B, et al.Development of participant-informed text messages to promote physicalactivity among African American women attending college: a qualitativemixed-methods inquiry. J Transcult Nurs. 2017;28(3):236–42.

74. Nicholson L. Development of key themes for physical activity promotion foradults - summary report; 2012.

75. Howle TC, Dimmock JA, Ntoumanis N, Chatzisarantis NLD, Sparks C, JacksonB. The impact of Agentic and communal exercise messages on Individuals'exercise class attitudes, self-efficacy beliefs, and intention to attend. J SportExerc Psychol. 2017;39(6):397.

76. Groshong L, Stanis SAW, Kaczynski AT, Hipp JA, Besenyi GM. Exploringattitudes, perceived norms, and personal agency: insights into theory-basedmessages to encourage park-based physical activity in low-income urbanneighborhoods. J Phys Act Health. 2017;14(2):108.

77. Berry T. Rethinking how physical activity messages are thought about:implications for successful promotion. WellSpring. 2017;28(3):1–4.

78. Hevel DJ, Amorose AJ, Lagally KM, Rinaldi-Miles A, Pierce S. Testing theeffects of messaging on physical activity motivation in active and non-active adults. Psychol Sport Exerc. 2019;43:333–42.

79. Rhodes R, Courneya K. Effects of a health-based versus appearance-basedpersuasive message on attitudes towards exercise: testing the moderatingrole of self-monitoring. J Soc Behav Pers. 2000;15(3):321.

80. Berry TR, Jones KE, McLeod NC, Spence JC. The relationship betweenimplicit and explicit believability of exercise-related messages andintentions. Health Psychol. 2011;30(6):746–52.

81. Bull FC, Kreuter MW, Scharff DP. Effects of tailored, personalized and generalhealth messages on physical activity. Patient Educ Couns. 1999;36(2):181–92.

82. Latimer AE, Rivers SE, Rench TA, Katulak NA, Hicks A, Hodorowski JK, et al. Afield experiment testing the utility of regulatory fit messages for promotingphysical activity. J Exp Soc Psychol. 2008;44(3):826–32.

83. Quintiliani LM, Campbell MK, Bowling JM, Steck S, Haines PS, DeVellis BM.Results of a randomized trial testing messages tailored to participant-selected topics among female college students: physical activity outcomes.J Phys Act Health. 2010;7(4):517–26.

84. Yan A, Stevens P, Wang Y, Weinhardt L, Holt C, O'Connor C, et al. MHealthtext messaging for physical activity promotion in college youth: aparticipatory approach. Ann Behav Med. 2015;49(s1):S201-S.

85. Kinnafick FE, Thogersen-Ntoumani C, Duda JL. The effect of need supportivetext messages on motivation and physical activity behaviour. 2016;39(4).

86. Bailis DS, Ashley Fleming J, Segall A. Self-determination and functionalpersuasion to encourage physical activity. Psychol Health. 2005;20(6):691–708.

87. Op Den Akker H, Cabrita M, Op Den Akker R, Jones VM, Hermens HJ.Tailored motivational message generation: A model and practicalframework for real-time physical activity coaching. J Biomed Inform. 2015;55:104–15.

88. Leone LA, Campbell MK, Allicock M, Pignone M. Colorectal Cancerscreening and physical activity promotion among obese women: an onlineevaluation of targeted messages. J Health Commun. 2012;17(10):1–17.

89. Thai CL, Taber JM, Oh A, Segar M, Blake K, Patrick H. "keep it realistic":reactions to and recommendations for physical activity promotionmessages from focus groups of women. Am J Health Promot. 2019;33(6):903–11.

90. Cheval B, Sarrazin P, Isoard-Gautheur S, Radel R, Friese M. Reflective andimpulsive processes explain (in)effectiveness of messages promotingphysical activity: a randomized controlled trial. Health Psychol. 2015;34(1):10–9.

91. Leahy J, Shugrue M, Daigle J, Daniel H. Local and visitor physical activitythrough media messages: a specialized benefits-based Manageentapplication at Acadia National Park. J Park Recreat Adm. 2009;27(3):59–77.

92. Berry T. Who’s even interested in the exercise message? Attentional bias forexercise and sedentary-lifestyle related words. J Sport Exerc Psychol. 2006;28(1).

93. Segar M, Taber JM, Patrick H, Thai CL, Oh A. Rethinking physical activitycommunication: using focus groups to understand women’s goals, values,and beliefs to improve public health. BMC Public Health. 2017;17.

94. Priebe CS, Spink KS. Using messages promoting descriptive norms toincrease physical activity. Health Commun. 2012;27(3):284–91.

95. Priebe CS, Spink KS. Less sitting and more moving in the office: usingdescriptive norm messages to decrease sedentary behavior and increaselight physical activity at work. Psychol Sport Exerc. 2015;19:76–84.

96. van Bavel R, Esposito G, Baranowski T. Is anybody doing it? An experimentalstudy of the effect of normative messages on intention to do physicalactivity.(Survey). BMC Public Health. 2014;14(1).

97. Crozier AJ, Taylor KL. An exploratory study examining the interactive effectof descriptive norm and image appeal messages on Adults' physical activity


intentions: a test of deviation regulation theory. J Health Commun. 2019;24(2):195–202.

98. Skapinsky KF, Persky S, Lewis M, Goergen A, Ashida S, de Heer HD, et al.Heart disease risk information, encouragement, and physical activity amongMexican-origin couples: self- or spouse-driven change? Transl Behav Med.2018;8(1):95–104.

99. Berry TR, Jones KE, Courneya KS, McGannon KR, Norris CM, Rodgers WM,et al. Believability of messages about preventing breast cancer and heartdisease through physical activity. BMC Psychol. 2018;6(1):2.

100. Albarracin D, Wang W, Leeper J. Immediate increase in food intakefollowing exercise messages. Obesity (Silver Spring, Md). 2009;17(7):1451.

101. Yun L, Ori EM, Younghan L, Sivak A, Berry TR. A systematic review ofcommunity-wide media physical activity campaigns: an update from 2010. JPhys Act Health. 2017;14(7):552–70.

102. Marcus B, Owen N, Forsyth L, Cavill N, Fridinger F. Physical activityinterventions using mass media, print media, and information technology.Am J Prev Med. 1998;15(4):362–78.

103. Marshall AL, Owen N, Bauman AE. Mediated approaches for influencingphysical activity: update of the evidence on mass media, print, telephoneand website delivery of interventions. J Sci Med Sport. 2004;7(1):74–80.

104. Bauman AE, Bellew B, Owen N, Vita P. Impact of an Australian mass mediacampaign targeting physical activity in 1998. Am J Prev Med. 2001;21(1):41–7.

105. Smith BJ, Bonfiglioli CMF. Physical activity in the mass media: an audienceperspective. Health Educ Res. 2015;30(2):359–69.

106. Saito Y, Oguma Y, Tanaka A, Kamada M, Inoue S, Inaji J, et al. Community-wide physical activity intervention based on the Japanese physical activityguidelines for adults: a non-randomized controlled trial. Prev Med. 2018;107:61–8.

107. Peterson M, Abraham A, Waterfield A. Marketing physical activity: lessonslearned from a statewide media campaign. Health Promot Pract. 2005;6(4):437–46.

108. Owen N, Bauman A, Booth M, Oldenburg B, Magnus P. Serial mass-mediacampaigns to promote physical activity: reinforcing or redundant? Am JPublic Health. 1995;85(2):244.

109. Booth M, Bauman A, Oldenburg B, Owen N, Magnus P. Effects of a NationalMass-Media Campaign on physical activity participation. Health Promot Int.1992;7(4):241–7.

110. Barnes R, Giles-Corti B, Bauman A, Rosenberg M, Bull F, Leavy J. Doesneighbourhood walkability moderate the effects of mass mediacommunication strategies to promote regular physical activity? Ann BehavMed. 2013;45(Supplement 1):86–94.

111. Leavy JE, Rosenberg M, Bauman AE, Bull FC, Giles-Corti B, Shilton T, et al.Effects of find thirty every day(R): cross-sectional findings from a WesternAustralian population-wide mass media campaign, 2008-2010. Health EducBehav. 2013;40(4):480–92.

112. Leavy JE, Rosenberg M, Bull FC, Bauman AE. Who do we reach? Campaignevaluation of find thirty every day(R) using awareness profiles in a WesternAustralian cohort. J Health Commun. 2014;19(7):853–69.

113. Beaudoin CE, Fernandez C, Wall JL, Farley TA. Promoting healthy eating andphysical activity: short-term effects of a mass media campaign. Am J PrevMed. 2007;32(3):217–23.

114. Leavy JE, Bauman AE, Rosenberg M, Bull FC. Examining the communicationeffects of health campaigns. SAGE Open. 2014;4(2):215824401453355.

115. Buller DB. Diffusion and dissemination of physical activity recommendationsand programs to world populations. Am J Prev Med. 2006;31(4):1–4.

116. Xia Y, Deshpande S, Bonates T. Effectiveness of social marketinginterventions to promote physical activity among adults: a systematicreview. J Phys Act Health. 2016;13(11):1263–74.

117. Lankford T, Wallace J, Brown D, Soares J, Epping J, Fridinger F. Analysis ofphysical activity mass media campaign design. J Phys Act Health. 2014;11(6):1065–9.

118. Berry TR, Spence JC, Plotnikoff RC, Bauman A. Physical activity informationseeking and advertising recall. Health Commun. 2011;26(3):246–54.

119. Rhee Y, Nyquist H, Garden-Robinson J, Brunt A. Promoting healthy eatingand exercise through online messages. J Am Diet Assoc. 2009;109(9):A53.

120. Berry TR, Witcher C, Holt NL, Plotnikoff RC. A qualitative examination ofperceptions of physical activity guidelines and preferences for format.Health Promot Pract. 2010;11(6):908–16.

121. Filion AJ, Darlington G, Chaput JP, Ybarra M, Haines J. Examining theinfluence of a text message-based sleep and physical activity intervention

among young adult smokers in the United States. BMC Public Health. 2015;15(671):671.

122. Suggs S, Blake H, Bardus M, Lloyd S. Effects of text messaging in addition toemails on physical activity among university and college employees in theUK. J Health Serv Res Policy. 2013;18(1_suppl):56–64.

123. McCoy P, Leggett S, Bhuiyan A, Brown D, Frye P, Williams B. Textmessaging: an intervention to increase physical activity among AfricanAmerican Participants in a Faith-Based, Competitive Weight Loss Program.Int J Environ Res Public Health. 2017;14(4).

124. Johnston C, Davis WE. Motivating exercise through social media: is a picturealways worth a thousand words? Psychol Sport Exerc. 2019;41:119–26.

125. Scarapicchia TMF, Sabiston CMF, Brownrigg M, Blackburn-Evans A, Cressy J,Robb J, et al. MoveU? Assessing a social marketing campaign to promotephysical activity. J Am Coll Health. 2015.

126. Graham DJ, Graham JF. Improving media campaigns promoting physicalactivity: the underutilized role of gender. Int J Nonprofit Volunt Sect Mark.2008;13(3):205–13.

127. Pena-Y-Lillo M, Lee C-J. A communication inequalities approach todisparities in physical activities: the case of the VERB campaign. J HealthCommun. 2019;24(2):111–20.

128. Notthoff N, Klomp P, Doerwald F, Scheibe S. Positive messages enhanceolder adults’ motivation and recognition memory for physical activityprogrammes. Soc Behav Health Perspec. 2016;13(3):251–7.

129. Li K, Lorna N, Sheung-Tak C, Helene HF, Li K-K, Ng L, et al. Reverse message-framing effects on accelerometer-assessed physical activity among olderoutpatients with type 2 diabetes. J Sport Exerc Psychol. 2017;39(3):222–7.

130. Sebastiao E, Chodzko-Zajko W, Schwingel A. The need to modify physicalactivity messages to better speak to older African American women: a pilotstudy.(Report). BMC Public Health. 2015;15(1).

131. Robin N, Toussaint L, Coudevylle GR, Ruart S, Hue O, Sinnapah S. Textmessages promoting mental imagery increase self-reported physical activityin older adults: a randomized controlled study. J Aging Phys Act. 2018;26(3):462–70.

132. Letts L, Martin Ginis KA, Faulkner G, Colquhoun H, Levac D, Gorczynski P.Preferred methods and messengers for delivering physical activityinformation to people with spinal cord injury: a focus group study. RehabilPsychol. 2011;56(2):128–37.

133. Harrison AL, Taylor NF, Frawley HC, Shields N. Women with gestationaldiabetes mellitus want clear and practical messages from credible sourcesabout physical activity during pregnancy: a qualitative study. J Phys. 2019;65(1):37–42.

134. Gaston A, Gammage K. Health versus appearance messages, self-monitoringand pregnant women’s intentions to exercise postpartum. J Reprod InfantPsychol. 2010;28(4):345–58.

135. Gaston A, Gammage K. The effectiveness of a health-based message onpregnant women’s intentions to exercise postpartum. J Reprod InfantPsychol. 2011;29(2):162–9.

136. Huberty JL, Buman MP, Leiferman JA, Bushar J, Hekler EB, Adams MA. Doseand timing of text messages for increasing physical activity amongpregnant women: a randomized controlled trial. Transl Behav Med. 2017;7(2):212–23.

137. Smith B, Wightman L. Promoting physical activity to disabled people:messengers, messages, guidelines and communication formats. DisabilRehabil. 2019;1.

138. Jaarsma EA, Haslett D, Smith B. Improving communication of informationabout physical activity opportunities for people with disabilities. Adapt PhysAct Q. 2019;36(2):185–201.

139. Bassett-Gunter RL, Ruscitti RJ, Latimer-Cheung AE, Fraser-Thomas JL.Targeted physical activity messages for parents of children with disabilities:a qualitative investigation of parents' informational needs and preferences.Res Dev Disabil. 2017;64:37–46.

140. Bassett-Gunter RL, Martin Ginis KA, Latimer-Cheung AE. Do you want thegood news or the bad news? Gain- versus loss-framed messages followinghealth risk information: the effects on leisure time physical activity beliefsand cognitions. Health Psychol. 2013;32(12):1188–98.

141. Tversky A, Kahneman D. The framing of decisions and the psychology ofchoice. Science. 1981;211(4481):453–8.

142. Green LW. Health promotion planning : an educational and ecologicalapproach. In: Kreuter MW, editor. . 3rd ed. Mountain View: Mayfield; 1999.

143. Hagger MS, Weed M. DEBATE: Do interventions based on behavioral theorywork in the real world?(Report). Int J Behav Nutr Phys Activity. 2019;16(1).


144. Kreuter M, Strecher V, Glassman B. One size does not fit all: the case fortailoring print materials. Ann Behav Med. 1999;21(4):276–83.

145. Marcus. Physical Activity Intervention Studies: What We Know and What WeNeed to Know: A Scientific Statement From the American Heart AssociationCouncil on Nutrition, Physical Activity, and Metabolism (Subcommittee onPhysical Activity); Council on Cardiovascular Disease in the Young; and theInterdisciplinary Working Group on Quality of Care and Outcomes Research(vol 114, pg 2739, 2006). Circulation. 2010;122(1):E8-E.

146. Napolitano AM, Marcus HB. Targeting and tailoring physical activityinformation using print and information technologies. Exerc Sport Sci Rev.2002;30(3):122–8.

147. Hastings G. Social marketing. Third edition.. ed. Domegan C, editor.Abingdon, Oxon ; New York, NY: Abingdon, Oxon ; New York, NY :Routledge; 2018.

148. Michie S, Prestwich A. Are interventions theory-based? Development of atheory coding scheme. Health Psychol. 2010;29(1):1–8.

149. US Department of Health and Human Services. Physical Activity Guidelinesfor Americans, 2nd Edition. In: Services DoHaH, editor. Washington, DC. USA.2018.

150. Brown W, Bauman A, Bull F, Burton N. Development of evidence-basedphysical activity recommendations for adults (18–64 years). Health AGDo,editor: In; 2012.

151. World Health Organization. Guidelines on physical activity, sedentarybehaviour and sleep for children under 5 years of age. Geneva; 2019.Contract No.: 23rd March 2020.

152. Spence JC, Brawley LR, Craig CL, Plotnikoff RC, Tremblay MS, Bauman A,et al. ParticipACTION: awareness of the participACTION campaign amongCanadian adults--examining the knowledge gap hypothesis and ahierarchy-of-effects model. Int J Behav Nutr Phys Activity. 2009;6(1):85.

Publisher’s NoteSpringer Nature remains neutral with regard to jurisdictional claims inpublished maps and institutional affiliations.


Get the message? A scoping review of physical activity messaging · 2020. 4. 15. · global burden...

Documents

Transcript of Get the message? A scoping review of physical activity messaging · 2020. 4. 15. · global burden...